U.S. patent application number 10/597605 was filed with the patent office on 2008-10-02 for methods and apparatuses for rehabilitation exercise and training.
This patent application is currently assigned to Motorika, Inc.. Invention is credited to Omer Einav.
Application Number | 20080242521 10/597605 |
Document ID | / |
Family ID | 34842044 |
Filed Date | 2008-10-02 |
United States Patent
Application |
20080242521 |
Kind Code |
A1 |
Einav; Omer |
October 2, 2008 |
Methods and Apparatuses for Rehabilitation Exercise and
Training
Abstract
A rehabilitation chair system, comprising: a seat adapted for
sitting of a human thereon; at least one extender adapted to move
relative to said seat; at least one sensor which generates an
indication of a balance state of said human; and a controller
configured to move said extender while measuring said balance state
using said at least one sensor.
Inventors: |
Einav; Omer; (Emek Hefer,
IL) |
Correspondence
Address: |
MARTIN D. MOYNIHAN d/b/a PRTSI, INC.
P.O. BOX 16446
ARLINGTON
VA
22215
US
|
Assignee: |
Motorika, Inc.
Road Town, Tortola
VG
|
Family ID: |
34842044 |
Appl. No.: |
10/597605 |
Filed: |
February 4, 2005 |
PCT Filed: |
February 4, 2005 |
PCT NO: |
PCT/IL2005/000136 |
371 Date: |
June 3, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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60542022 |
Feb 5, 2004 |
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60566079 |
Apr 29, 2004 |
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60633429 |
Dec 7, 2004 |
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60633442 |
Dec 7, 2004 |
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60633428 |
Dec 7, 2004 |
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Current U.S.
Class: |
482/110 ; 482/8;
482/9 |
Current CPC
Class: |
A63B 71/0009 20130101;
A61B 2505/09 20130101; A61B 5/1116 20130101; G16H 20/30 20180101;
A63B 26/003 20130101; A61B 5/6891 20130101; A61B 5/4519 20130101;
A63B 2208/0233 20130101; A61B 5/6887 20130101; A63B 2071/0018
20130101; A61B 5/103 20130101; A61B 5/392 20210101; A61B 5/702
20130101; A61B 5/4528 20130101; A61B 5/4023 20130101 |
Class at
Publication: |
482/110 ; 482/8;
482/9 |
International
Class: |
A63B 21/22 20060101
A63B021/22; A63B 71/00 20060101 A63B071/00 |
Claims
1. A rehabilitation chair system, comprising: a seat adapted for
sitting of a human thereon; at least one extender adapted to move
relative to said seat; at least one sensor which generates an
indication of a balance state of said human; and a controller
configured to move said extender while measuring said balance state
using said at least one sensor.
2. A system according to claim 1, wherein said extender is
mechanically coupled to said seat.
3. A system according to claim 1, wherein said controller moves
said extender responsive to said balance state.
4. A system according to claim 1, wherein said controller moves
said extender and measures a responsive change in balance
state.
5. A system according to claim 1, wherein said seat is adapted to
rotate out of plane of the seat.
6. A system according to claim 1 wherein said seat comprises a
back.
7. A system according to claim 6, wherein said back is
articulated.
8. A system according to claim 6, wherein said back rotates around
a vertical axis thereof.
9. A system according to claim 1, wherein said seat is adapted to
resist said rotating thereof.
10. A system according to claim 1, wherein said seat is adapted to
lift under power at least 10 cm.
11. A system according to claim 1, comprising at least one leg
mover adapted to lift at least one leg of the human from a floor on
which the leg rests.
12. A system according to claim 11, comprising at least a second
leg mover adapted to lift at least a second leg from said
floor.
13. A system according to claim 12, wherein said leg movers are
adapted to be locked together.
14. A system according to claim 12, wherein said leg movers are
separately movable.
15. A system according to claim 1, wherein said at least one
balance sensor comprises at least one pressure mat for a foot of
the human.
16. A system according to claim 1, wherein said at least one sensor
comprises at least one pressure sensor for an armrest of said
chair.
17. A system according to claim 1, wherein said at least one sensor
comprises at least one pressure sensor positioned on the seat for a
buttock.
18. A system according to claim 1, wherein said at least one sensor
comprises at least one pressure sensor positioned to be placed on a
table near said chair.
19. A system according to claim 1, wherein said at least one sensor
comprises at least two pressure sensors symmetrically positioned
relative to a person sitting in the chair.
20. A system according to claim 1, wherein said at least one sensor
comprises at least four spatially separated pressure sensors.
21. A system according to claim 1, wherein said controller drives
said extendor according to a rehabilitation plan stored within the
controller.
22. A system according to claim 1, wherein said controller drives
said seat according to a rehabilitation plan stored within the
controller.
23. A rehabilitation system comprising: a joint having a common
center of rotation for rotation (Phi) and elevation (Theta) angles;
a seat mounted on said joint; and a controller adapted to perform
at least one of: drive said seat and measure a rotation of said
seat, according to a rehabilitation plan.
24. A rehabilitation system comprising: a chair adapted for sitting
of a human thereon; a leg lift mechanism adapted to lift at least
one leg of a human sitting on the chair; and a controller adapted
to control the lift mechanism to repeatedly lift the at least one
leg of the human, such that a spine of the human is
manipulated.
25. A method of rehabilitation of a person, comprising: sitting the
person in a chair coupled to a robotic assistance device; and
performing, with robotic assistance of said device, at least one
rehabilitation exercise on said person, said exercise designed to
rehabilitate balance, said robotic assistance including at least
one of providing motive force by said robotic assistance and
providing an obstruction to motion by said robotic assistance.
26. A method according to claim 25, wherein said exercise comprises
reaching one or more hands.
27. A method according to claim 25, wherein said exercise comprises
lifting and placing an object.
28. A method according to claim 25, wherein said exercise comprises
a manipulation of hands extended away from the body.
29. A method according to claim 25, wherein said exercise comprises
an interactive exercise with feedback as the complexity of the
exercise increases.
30. A method according to claim 25, wherein said performing
comprises monitoring a plurality of body parts.
31. A method according to claim 25, comprising monitoring a balance
between body sides of the person while performing the exercise.
32. A method according to claim 25, comprising monitoring positions
of an organ of the person and analyzing the positions to determine
an assistance of the organ to a balance of the person.
33. A method according to claim 32, wherein the organ comprises an
arm.
34. A method according to claim 32, wherein the organ comprises a
torso.
35. A method according to claim 32, wherein the organ comprises a
leg.
36. A method according to claim 32, wherein monitoring positions of
the organ comprises monitoring movements of the organ.
37. A method according to claim 32, wherein monitoring positions of
the organ comprises monitoring resistance of the organ to motion of
another body part.
38. A method according to claim 25, wherein said robotic assistance
comprises moving a body part.
39. A method according to claim 25, wherein said robotic assistance
comprises resisting the motion of a body part.
40. A method according to claim 25, wherein said robotic assistance
comprises preventing loss of balance.
41. A method according to claim 25, wherein said robotic assistance
comprises inducing loss of balance.
42. A method according to claim 25, wherein said exercise comprises
standing up.
43. A method according to claim 42, wherein said robotic assistance
lifts said person.
44. A method according to claim 25, wherein said exercise comprises
torso training.
45. A method of balance rehabilitation comprises: performing by a
person a task requiring balancing; and monitoring a performance of
said task by measuring forces at a plurality of spatially separate
load areas on which the person applies force, including at least
one load area other than a foot.
Description
RELATED APPLICATIONS
[0001] This application claims the benefit under 119(e) of U.S.
Provisional Application No. 60/542,022 filed on Feb. 5, 2004, U.S.
Provisional Application No. 60/566,079 filed on Apr. 29, 2004, U.S.
Provisional Application No. 60/633,428 filed on Dec. 7, 2004, U.S.
Provisional Application No. 60/633,429 filed on Dec. 7, 2004 and
U.S. Provisional Application No. 60/633,442 filed on Dec. 7, 2004
the disclosures of which are incorporated herein by reference.
[0002] This application is also related to PCT applications, being
filed on same date and by the same applicant as the present
application, entitled "Gait Rehabilitation Methods and
Apparatuses"; "Rehabilitation with Music"; "Neuromuscular
Stimulation"; "Fine Motor Control Rehabilitation"; "Methods and
Apparatus for Rehabilitation and Training"; "Methods and Apparatus
for Rehabilitation and Training"; "Methods and Apparatus for
Rehabilitation and Training"; and having attorney docket numbers,
414/04391; 414/04396; 414/04400; 414/04401; 414/04213, 414/04213;
414/04404 and 414/04405, respectively. The disclosures of all these
applications are incorporated herein by reference.
FIELD OF THE INVENTION
[0003] The present invention relates to manipulation of body parts,
for example for physical rehabilitation and/or rehabilitation of
balance disorders and/or training body parts and/or treatment of
pain and/or exercise.
BACKGROUND OF THE INVENTION
[0004] After accidents or injuries or strokes, some body functions
are damaged and persons often need a rehabilitation process in an
attempt to recapture some or all of the damaged body functions.
[0005] Rehabilitation may include one or both of two elements:
physical rehabilitation and cognitive rehabilitation. Physical
rehabilitation attempts to restore physical functioning of damaged
body parts, such as muscles. Cognitive rehabilitation attempts to
restore cognitive abilities to control the body.
[0006] Physical rehabilitation is presently mainly provided by
personal attention of a physical therapist that monitors and
instructs a patient in performing of certain exercises. Thus, costs
for rehabilitation are high and compliance after a patient leaves a
treatment center is relatively low.
[0007] Some home physical therapy devices are known, for example a
product called "backlife", which is described in
(www.backlife.com), as on November 2004, provides Continuous
Passive Movement ("CPM") of the spine and is also used to relieve
back pain.
[0008] Accidents or strokes or injuries may cause balance
disorders. Balance disorders may occur from damage to the
vestibular apparatus (centered in the inner ear), damage to the
central nervous system ("CNS"), and/or from postural and strength
deficits.
[0009] Balance tests, either observational or computerized for
detecting and classifying balance disorders have been developed.
Balance training exercises are used to treat balance disorders.
Known balance-training exercises are "stand from sitting position",
"stand on one leg" and "bend forward so you may pick an object from
the floor". Balance training can utilize simple tools such as
inflatable balance discs, foam rollers, wobble boards, foam pads,
mini-trampolines, and other unstable surfaces. An exercise
utilizing a wobble board can be for example "while balancing on a
wobble board, catch and toss a small light weight ball".
[0010] The following three patents relate to balance testing and/or
movement coordination: U.S. Pat. No. 5,269,318, U.S. Pat. No.
5,476,103 and WIPO Publication No. WO 98/46127 entitled "Method and
apparatus for the diagnosis and rehabilitation of balance
disorders".
[0011] Several companies developed balance measurement and/or
balance treatment devices. NeuroCom (www.neurocom.com) has several
devices for rehabilitation. The Smart Balance-Master from NeuroCom
is a posturography training device. It involves a moving platform
coupled to a computer monitor. K.A.T. (Kinesthetic Ability Trainer)
from www.medfitsystems.com is used for balance testing and/or
balance training. Other known devices are BalanceQuest and System
2000 from Micromedical Technologies (www.micromedical.com). System
2000 is a rotational vestibular chair.
[0012] U.S. Publication No. 2002/115536 entitled "Balance training
device" describes a device that has a seat and performs
horse-riding motions.
[0013] A rehabilitation system is described in U.S. Pat. No.
6,774,885 assigned to Motek B.V. and is also described in
(www.e-motek.com). CAREN--a Computer Assisted Rehabilitation
Environment is described in U.S. Pat. No. 6,774,885. CAREN helps
view and analyze balance and coordination disorders.
[0014] Patent EP 0 862 930 entitled "An Interactive device with a
balance plate" describes a balance plate for training and
rehabilitation of equilibrium capacity.
[0015] The disclosures of all patents and other publications
mentioned in this patent application are incorporated herein by
reference.
SUMMARY OF THE INVENTION
[0016] An aspect of some embodiments of the invention relates to
rehabilitation of a patient while the patient is in a sitting
position. In an exemplary embodiment of the invention, a
rehabilitation chair system is provided which senses and/or
actuates portions of the patient, while sitting down. In an
exemplary embodiment of the invention, the chair is selectively
unstable. Optionally, the chair is used to rehabilitate balance
abilities.
[0017] In an exemplary embodiment of the invention, a
rehabilitation chair system, comprises a seat adapted for sitting
of a human; at least one extender (e.g., extendible and/or
articulating element such as a robotic arm) adapted to move
relative to said seat; at least one sensor which generates an
indication of a balance state of said human; and a controller
configured to move the extender while measuring the balance state
using the sensor.
[0018] In an exemplary embodiment of the invention, rehabilitation
includes moving body parts while not losing ones balance.
Optionally, the chair system assists a patient in not losing
balance.
[0019] A particular feature of some embodiments of the invention is
that balance training includes targets that provide real
kinesthetic feedback. In one example, a target is a moving robotic
arm, which once reached can be grasped and leaned on. Forces
associated with such movements can be measured as well.
Alternatively or additionally, during a balancing or unbalancing
activity direct mechanical contact between the moving parts of a
patient and a chair may assist in teaching a patient about his
kinesthetic sense and/or provide support. Alternatively or
additionally, the use of physical motion may be useful for
bypassing various cognitive problems associated with strokes.
[0020] An aspect of some embodiments of the invention relates to
providing a portable rehabilitation system for use in locations
such as small clinics, homes, offices, outdoors or places of
work.
[0021] In an exemplary embodiment of the invention, a
rehabilitation chair system is controlled according to a program.
Optionally, the program is devised using measurements and tests on
a plurality of patients.
[0022] In an exemplary embodiment of the invention a plurality of
different training programs can be predefined (set). Optionally,
programs are tailored to patient parameters. Exemplary parameters
are body size and age.
[0023] An aspect of some embodiments of the invention relates to
treatment and/or rehabilitation of balance disorders. In an
exemplary embodiment of the invention, such disorders are treated
by rehabilitating using exercises specific to problematic body
parts, exercise which coordinate between body parts and/or
exercises in which a balancing task of reduced complexity is
supported by the chair.
[0024] An aspect of some embodiments of the invention relates to
rehabilitation of balance in which multiple load areas are
measured, for example, at least one load area in addition to feet.
In an exemplary embodiment of the invention, load on a leaning arm
is measured. Alternatively or additionally, load on a buttock is
measured.
[0025] An aspect of some embodiments of the invention relates to
interactive rehabilitation, in which a complex task is broken into
progressive sub-tasks and feedback can be provided during such
sub-tasks. In an exemplary embodiment of the invention, a reaching
task is provided in which as a person reaches farther, the
balancing becomes more complex. Feedback regarding balancing is
optionally provided as the reaching progresses.
[0026] An aspect of some embodiments of the invention relates to
treatment and/or prevention of body aches and pains, such as back
pain. In an exemplary embodiment of the invention, a chair system
can be used to exercise a back and/or or associated muscle and/or
skeleton parts, while is a supported position. Optionally, such
exercising is sued for patients after back surgery. Optionally, CPM
motion of the spine is supported.
[0027] There is thus provided in accordance with an exemplary
embodiment of the invention a rehabilitation chair system,
comprising:
[0028] a seat adapted for sitting of a human thereon;
[0029] at least one extender adapted to move relative to said
seat;
[0030] at least one sensor which generates an indication of a
balance state of said human; and
[0031] a controller configured to move said extender while
measuring said balance state using said sensor.
[0032] There is also provided in accordance with an exemplary
embodiment of the invention a method for rehabilitation,
comprising:
[0033] identifying human body parts that need rehabilitation and
exercising at least one of said body parts using a chair system
which includes moving parts that are adapted to be coupled to body
limbs. Optionally, the rehabilitation needed and the exercises are
for balance rehabilitation.
[0034] There is also provided in accordance with an exemplary
embodiment of the invention, a rehabilitation chair system,
comprising:
[0035] a seat adapted for sitting of a human thereon;
[0036] at least one extender adapted to move relative to said
seat;
[0037] at least one sensor which generates an indication of a
balance state of said human; and
[0038] a controller configured to move said extender while
measuring said balance state using said at least one sensor.
Optionally, said extender is mechanically coupled to said seat.
Alternatively or additionally, said controller moves said extender
responsive to said balance state. Alternatively or additionally,
said controller moves said extender and measures a responsive
change in balance state. Alternatively or additionally, said seat
is adapted to rotate out of plane of the seat.
[0039] In an exemplary embodiment of the invention, said seat
comprises a back. Optionally, said back is articulated.
Alternatively or additionally, said back rotates around a vertical
axis thereof.
[0040] In an exemplary embodiment of the invention, said seat is
adapted to resist said rotating thereof.
[0041] In an exemplary embodiment of the invention, said seat is
adapted to lift under power at least 10 cm.
[0042] In an exemplary embodiment of the invention, the system
comprises at least one leg mover adapted to lift at least one leg
of the human from a floor on which the leg rests. Optionally, the
system comprises at least a second leg mover adapted to lift at
least a second leg from said floor. Optionally, said leg movers are
adapted to be locked together. Alternatively or additionally, said
leg movers are separately movable.
[0043] In an exemplary embodiment of the invention, said at least
one balance sensor comprises at least one pressure mat for a foot
of the human.
[0044] In an exemplary embodiment of the invention, said at least
one sensor comprises at least one pressure sensor for an armrest of
said chair.
[0045] In an exemplary embodiment of the invention, said at least
one sensor comprises at least one pressure sensor positioned on the
seat for a buttock.
[0046] In an exemplary embodiment of the invention, said at least
one sensor comprises at least one pressure sensor positioned to be
placed on a table near said chair.
[0047] In an exemplary embodiment of the invention, said at least
one sensor comprises at least two pressure sensors symmetrically
positioned relative to a person sitting in the chair.
[0048] In an exemplary embodiment of the invention, said at least
one sensor comprises at least four spatially separated pressure
sensors.
[0049] In an exemplary embodiment of the invention, said controller
drives said extender according to a rehabilitation plan stored
within the controller.
[0050] In an exemplary embodiment of the invention, said controller
drives said seat according to a rehabilitation plan stored within
the controller.
[0051] There is also provided in accordance with an exemplary
embodiment of the invention, a rehabilitation system
comprising:
[0052] a joint having a common center of rotation for rotation
(Phi) and elevation (Theta) angles;
[0053] a seat mounted on said joint; and
[0054] a controller adapted to perform at least one of: drive said
seat and measure a rotation of said seat, according to a
rehabilitation plan.
[0055] There is also provided in accordance with an exemplary
embodiment of the invention, a rehabilitation system
comprising:
[0056] a chair adapted for sitting of a human thereon;
[0057] a leg lift mechanism adapted to lift at least one leg of a
human sitting on the chair; and
[0058] a controller adapted to control the lift mechanism to
repeatedly lift the at least one leg of the human, such that a
spine of the human is manipulated.
[0059] There is also provided in accordance with an exemplary
embodiment of the invention, a method of rehabilitation of a
person, comprising:
[0060] sitting the person in a chair coupled to a robotic
assistance device; and
[0061] performing, with robotic assistance of said device, at least
one rehabilitation exercise on said person, said exercise designed
to rehabilitate balance, said robotic assistance including at least
one of providing motive force by said robotic assistance and
providing an obstruction to motion by said robotic assistance.
Optionally, said exercise comprises reaching one or more hands.
Alternatively or additionally, said exercise comprises lifting and
placing an object.
[0062] In an exemplary embodiment of the invention, said exercise
comprises a manipulation of hands extended away from the body.
[0063] In an exemplary embodiment of the invention, said exercise
comprises an interactive exercise with feedback as the complexity
of the exercise increases.
[0064] In an exemplary embodiment of the invention, said performing
comprises monitoring a plurality of body parts.
[0065] In an exemplary embodiment of the invention, the method
comprises monitoring a balance between body sides of the person
while performing the exercise.
[0066] In an exemplary embodiment of the invention, the method
comprises monitoring positions of an organ of the person and
analyzing the positions to determine an assistance of the organ to
a balance of the person. Optionally, the organ comprises an arm.
Alternatively or additionally, the organ comprises a torso.
Alternatively or additionally, the organ comprises a leg.
[0067] In an exemplary embodiment of the invention, monitoring
positions of the organ comprises monitoring movements of the
organ.
[0068] In an exemplary embodiment of the invention, monitoring
positions of the organ comprises monitoring resistance of the organ
to motion of another body part.
[0069] In an exemplary embodiment of the invention, said robotic
assistance comprises moving a body part.
[0070] In an exemplary embodiment of the invention, said robotic
assistance comprises resisting the motion of a body part.
[0071] In an exemplary embodiment of the invention, said robotic
assistance comprises preventing loss of balance.
[0072] In an exemplary embodiment of the invention, said robotic
assistance comprises inducing loss of balance.
[0073] In an exemplary embodiment of the invention, said exercise
comprises standing up.
[0074] In an exemplary embodiment of the invention, said robotic
assistance lifts said person.
[0075] In an exemplary embodiment of the invention, said exercise
comprises torso training.
[0076] There is also provided in accordance with an exemplary
embodiment of the invention, a method of balance rehabilitation
comprises:
[0077] performing by a person a task requiring balancing; and
[0078] monitoring a performance of said task by measuring forces at
a plurality of spatially separate load areas on which the person
applies force, including at least one load area other than a
foot.
BRIEF DESCRIPTION OF THE FIGURES
[0079] Non-limiting embodiments of the invention will be described
with reference to the following description of exemplary
embodiments, in conjunction with the figures. The figures are
generally not shown to scale and any sizes are only meant to be
exemplary and not necessarily limiting. In the figures, identical
structures, elements or parts that appear in more than one figure
are preferably labeled with a same or similar number in all the
figures in which they appear, in which:
[0080] FIG. 1 is a schematic showing of a chair based
rehabilitation system, in accordance with an exemplary embodiment
of the invention;
[0081] FIG. 2 is a schematic showing a rehabilitation chair, in
accordance with an exemplary embodiment of the invention;
[0082] FIG. 3 is a flowchart of a method of using a rehabilitation
chair, in accordance with an exemplary embodiment of the
invention;
[0083] FIG. 4 is an illustration of a person being trained with a
rehabilitation chair, in accordance with an exemplary embodiment of
the invention;
[0084] FIG. 5 is a flowchart of a method of using a rehabilitation
chair, in accordance with an exemplary embodiment of the
invention;
[0085] FIG. 6 is a schematic showing of a basic chair based
rehabilitation device, in accordance with an exemplary embodiment
of the invention;
[0086] FIG. 7 is a flowchart of a method of using a rehabilitation
chair, in accordance with an exemplary embodiment of the
invention;
[0087] FIG. 8 is an illustration of a person being trained with a
rehabilitation chair, in accordance with an exemplary embodiment of
the invention;
[0088] FIGS. 9A, 9B and 9C illustrate a training method and a
version of rehabilitation chair, in accordance with an exemplary
embodiment of the invention;
[0089] FIG. 10 is an illustration of a rehabilitation chair showing
various ranges of movement in an exemplary embodiment of the
invention;
[0090] FIGS. 11 and 12 illustrate a training method and a version
of rehabilitation chair, in accordance with an exemplary embodiment
of the invention;
[0091] FIG. 13 illustrates a version of rehabilitation chair, in
accordance with an exemplary embodiment of the invention;
[0092] FIGS. 14A, 14B and 14C illustrate helping a person to move
from sitting to standing and using a rehabilitation chair, in
accordance with an exemplary embodiment of the invention;
DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS
General
[0093] The following description includes both rehabilitation
apparatuses and rehabilitation methods. Described is a
rehabilitation apparatus in an exemplary embodiment of the
invention and optional methods to be performed using the apparatus.
It should be noted that the usage of a particular apparatus
embodiment for certain methods is to illustrate the particular
methods, and should not be construed as limiting the apparatus or
the method to the particular combination of apparatus embodiment
and method embodiment.
Rehabilitation Chair System
[0094] In an exemplary embodiment of the invention, the
rehabilitation apparatus is a chair, however other rehabilitation
apparatuses such as a wobble board or platform are optionally used.
FIG. 1 is a schematic showing of a rehabilitation chair system 100,
in accordance with an exemplary embodiment of the invention. Person
or patient 104 sits on a rehabilitation chair 110. The chair system
100 can be used to train various body parts of the person 104 for
rehabilitation purposes and/or treatment of pain. As described
herein, the chair system 100 can be used to help recovery and/or
training and/or improve movement of body parts such as arms or
legs, of the person 104. Optionally sensors 130 are placed on the
patient.
[0095] System 100 acquires data and transfers it to controller 150.
Data such as positions and orientations of chair movable parts
and/or person's body parts may be acquired by chair 110 and
transferred by the chair to the controller. Data may be acquired,
by data acquisition unit 140, from sensors 130 attached to the
person, and transferred to controller 150.
[0096] The controller runs various programs and processes data
transferred to it. The controller then provides feedback, such as
physical updating of the chair by moving chair parts to certain
positions. The controller can also provide other types of feedback,
for instance updating a display 160. Additional information about
controller 150 is described in section "controller" below.
Rehabilitation Using a Chair System
[0097] FIG. 2 illustrates a rehabilitation chair 110, in accordance
with an exemplary embodiment of the invention. Parts comprising
this chair are described below, for instance, when describing
methods that make use of the chair.
[0098] Flowchart 300 of FIG. 3 together with FIG. 1 describes a
method of rehabilitation in an exemplary embodiment of the
invention. Later below a plurality of chair designs are described
and various rehabilitation methods that can be performed with those
chairs are described. For example, a rehabilitation method
described below is physically assisting a patient to move the
patient arms and in this way train the patient arms.
[0099] At act 302, various measurements of patient 104 parameters
and/or of chair 110 parameters are performed. The measurements
involve using various sensors. Sensors may be part of the chair 110
and indicate, for example an off-balance position of the chair.
Optionally sensors, such as 130, are attached to the person 104 and
indicate, for example, a body position and/or exerted force.
[0100] In an exemplary embodiment of the invention, a balance state
of a person may be extracted from the indications, indicating the
type and/or quality of balance of the person. In one example, an
"off-balance" situation is identified when chair 110 is supporting
the person unevenly. In another example, a balance state indicates
the balance between forces applied on either part of the body. In
another example, the balance state includes an indication of the
role of various supports (such as chair back and leg supports) in
maintaining the balance. In another example, the balance state
includes an indication of the relative center of gravity and the
support (e.g., chair seat) to indicate stability. In another
example, the balance state indicates the stability based on type,
amplitude, organization and/or existence of rhythmic motion of the
person, for example in shifting loads between different support
positions.
[0101] At act 304 the measurements are used to update various
elements of system 100, such as, a training program for the patient
and/or moving chair parts to certain positions. Moving chair parts
can assist the person in carrying out tasks and/or provide
biofeedback to the person. In an exemplary embodiment of the
invention, the moving chair parts are used to set up a target for
the patient to reach or to prevent his falling out.
[0102] At act 306 patient's body parts are exercised (trained)
individually or together. Usually training is according to a
program. Optionally a program runs on controller 150. A program may
be prepared in advance, and may be devised conducting preliminary
tests. In one example, the program is (in a very simplified form):
"first train in sitting straight without support and then train
with an unbalanced chair". More details are described below.
[0103] At act 308 it is determined if the patient should continue
exercise. Rehabilitation sessions may continue a significant period
of time, for example, daily or twice weekly for several weeks or
months. Over this time period, the type, complexity and/or
difficulty of exercises performed may change.
[0104] FIG. 4 illustrates training one arm of person 104 using
chair 110. Later below, training methods and motions, such as
motions of arms and motions of legs, are described.
"Go with" Method
[0105] Flowchart 500 in FIG. 5 describes a method ("go with"
method) that can be used for balance training and for
rehabilitation of a patient's back. This method is illustrated with
the chair of FIG. 2. At act 502, patient 104 is positioned on chair
110. The patient sits on seat 105 and his arms are placed on
armrests 250 and 252. Armrest 250 in FIG. 2 is optionally comprised
of various harnesses 256 and 258, and a harness support 257 which
are optionally used depending on each individual patient's need.
Arm rest can optionally be floating (e.g. by using air spring) so
it can at least partially support the patient's hand. The patient
is required to move with the movement of the chair arms while
maintaining his balance. The chair may be stable or unstable and
various levels of support may be provided (e.g., high or low chair
back, chair arms, foot rest, straps (for torso, arms and/or legs)
and/or a harness).
[0106] At act 504 a training program, for instance to carry out a
"go with" method, is determined.
[0107] At act 505 the person is instructed what to do. Instruction
can be audio and/or video, possibly using a computer generated
video generated on the fly by system 100 according to the action to
be performed. Optionally, instructions are conveyed to the patient
using a virtual reality presentation. In an exemplary embodiment of
the invention, system 100 is used to give a demonstration, while a
user is holding on or not.
[0108] At act 506 chair arms 230 and 232 move towards the hands of
the patient at a position that the patient can grab or hold the
chair arms. A patient 104 holds a chair arm at a chair arm tip (act
508). Chair arm tip 240 is attached to chair arm 230 and chair arm
tip 242 is attached to arm 232. Optionally, various handles,
restraints, sensors and/or moving elements are attached to the
chair arms 230 and/or 232. In an exemplary embodiment of the
invention, an element which gives a sensation of a force field is
provided. In another example, a separate element for moving a wrist
is provided. In some embodiments of the invention, a sensation
attachment is included that provides the patient with varying
touch-related sensations, such as tickling. Optionally, the patient
uses a sensation attachment for therapy involving surface textures,
for example identifying roughness and/or smoothness.
[0109] In an exemplary embodiment of the invention, each chair arm
is connected to a ball based mechanism that allows movements of the
chair arm, see FIG. 2. In particular chair arm 230 is connected to
ball based mechanism 224 and chair arm 232 is connected to ball
based mechanism 220. In an exemplary embodiment of the invention,
the ball mechanism includes a brake for applying varying force.
Optionally the brake is a ring that applies selectable force to the
ball as the ring is brought closer to the ball's center.
Optionally, the ball is moved using one or more motors, for example
stepper and/or servo motors. A handle on the ball is optionally
moved using a linear actuator. Encoders for determining chair arm
position and/or force sensors for determining chair arm forces are
optionally provided. Alternatively, robotic articulated arms may be
used.
[0110] The chair arms are provided with movement in the x, y and z
axes through the ball mechanisms 220 and 224. For example, the
patient 104 can use the chair arms 230, 232 to simulate a rowing
motion. Optionally, the chair arms 230, 232 can be used to simulate
a cross country skiing motion. The chair arms can be moved opposite
of each other, for example in a walking motion (right arm forward,
left arm back). It should be noted that the chair arms 230, 232
optionally operate and move independently of each other. Optionally
a chair arm is an articulated arm, which supports movement in 3D
space. In an exemplary embodiment of the invention, at least one
chair arm is provided with up to six degrees of freedom. Optionally
at least one chair arm is telescoping, adjusting the heights of the
arm tips 240 and 242. Alternatively, the chair arms may be set up
to act in mirror of each other, for example, a master-slave
relationship in which one chair arm causes movement of the other
chair arm. In an exemplary embodiment of the invention, the
master-slave relationship is implemented through the controller or
through a mechanical linkage.
[0111] In the "go with" method, at act 510 at least one chair arm
230 and/or 232 moves in relation to the patient 104. As the chair
arm moves, the patient is instructed to try to maintain a hand hold
on the chair arm tip. The arm can move in any direction relative to
the patient, away from or towards, up or down, left or right, or
any of these directions in combination. Chair arm motion can be
fast or slow, the speed of motion is variable. In an exemplary
embodiment of the invention, the chair 110 also moves, as described
in below, and is utilized to provide additional varieties of motion
in relation to the chair arms 230 and/or 232. In some cases, the
patient is instructed to apply and/or maintain a certain force
level and/or a varying force level. Such force levels may be
indicated by the response of the chair arm, which may allow motion
in one trajectory, optionally with resistance, but not allow motion
in other directions.
[0112] As the patient moves to "go with" the moving arm, sensors
130 optionally attached to both the patient and the chair register
the movements of the patient relative to the chair and chair arms
at act 512. In an exemplary embodiment of the invention, sensors
determine the position of chair parts such as chair arm 230 and/or
arm 232 and/or tip 240 and/or tip 242.
[0113] At act 514, analysis is carried out by system 100. The
analysis can be used to modify the training program and/or to move
various chair parts and/or provide other feedback to the person
104. In an exemplary embodiment of the invention, controller 150
analyzes balance and coordination movement patterns as they happen.
This enables the chair system 100 to immediately intervene and
influence and/or correct the patient's movements. For example,
sensors 130 can detect if the patient 104 is leaning too far or is
exerting an inordinate amount of pressure on a chair arm such that
if allowed to continue, the patient would fall out of the chair or
possibly sustain further injury. In an instance such as described,
the chair could compensate by tilting backwards to force the
patient to settle backwards into the chair, thereby avoiding a
patient fall. In addition to providing correcting chair movements
based on sensor readings, the patient and a supervising health care
professional can examine and analyze the sensor readings in order
to measure patient progress and determine further rehabilitation
strategy. It should be noted that corrective movements can also be
instigated by the chair arms 230 and/or 232. At act 516 it is
determined if the patient should continue exercise.
[0114] In an exemplary embodiment of the invention, controller 150
controls chair 110, according to a program. The controller controls
for instance movable parts such as chair arms 230 and/or 232. The
controller executes a rehabilitation method, such as the method of
flowchart 500.
Motions of a Seat
[0115] FIG. 6 is a schematic showing of a basic chair 600, which is
a version of chair 110, in accordance with an exemplary embodiment
of the invention. Both chairs 110 and 600 comprise a seat 105; a
base 214; an optional ball-based mechanism, or other rotary ball
bearing arrangement (e.g. a dual gimbal) 222 that connects to the
seat and controls seat movements. FIG. 6 shows also a brake
mechanism (620). Brake mechanisms can be used to control the
movement of the chair along particular axes. For example, if
movement along the x axis is undesirable, a brake can be applied to
the surface of the ball mechanism 222 to prevent movement of the
chair in that direction. Brakes are generally less expensive than
motors and require less power. FIG. 6 demonstrates some possible
movements of seat 105. Three types of movements of the seat, in X-Y
direction (612), in X-Z direction (614), and in Z direction (616)
are shown; however movement combining all three axes is possible.
In addition, translation motions along the X-Y plane can be
provided, for example using suitable linear actuators.
[0116] In an exemplary embodiment of the invention the controller
150 may transmit X axis, Y axis, and Z axis positions and rotations
to chair 600. For example, if a person 104 leans forward, the chair
110 would respond and adjust the seat 105 according to a training
program.
[0117] In an exemplary embodiment of the invention, the seat and/or
the seat back can rotate around the seat vertical axis. Optionally,
this rotation is used to assist or resist torso rotation by a
patient. Optionally, the seat back is divided into parts, so, for
example, the shoulder section of the seat back can rotate while the
lumber section of the seat back remains static.
[0118] In an exemplary embodiment of the invention, the seat 105 is
moved by the controller 150 while the patient 104 remains
substantially stationary. This is desirable when the posture of the
patient 104 is measured, for instance.
[0119] In an exemplary embodiment of the invention, the patient is
exercised by moving the chair 110 or chair arms 230 and/or 232 such
that the patient must move with the chair and/or chair arms while
trying to maintain balance. The pressure exerted by the patient on
various chair parts, including the chair arms, is measured and
analyzed. Optionally, this is achieved by having the patient hold
the chair arm tips 240, 242 as they move and then using sensors
attached to various system parts such as the chair arms, chair arm
tips, and/or a foot rest (or floor mat) to gauge the force applied
by the patient.
[0120] In an exemplary embodiment of the invention, the chair is
allowed to rotate and pivot freely, or at a reduced rate (e.g.,
using the brake), wherein the patient must balance the chair
without assistance from the controller 150. As the patient corrects
to maintain balance in the chair, the patient's movements can be
measured and analyzed in order to measure rehabilitation progress
and to formulate further rehabilitation strategy. Optionally, the
patient balances the chair while also using chair arms 230 and/or
232. In particular, what might be measured is unbalanced
application of forces, differences in time in application of forces
(between sides) and the activity of back and stomach muscles (e.g.,
as measured by EMG).
[0121] FIG. 10 depicts three basic axes of motion 1002, 1004, and
1006 that are possible with an exercise chair 1000, in an exemplary
embodiment of the invention. 1002 is motion of the chair 1000 in a
z-axis. Arrows 1004 and 1006 symbolize exemplary rotational motions
which can be achieved as a result of mounting the chair on a
gimbal.
[0122] FIG. 13 depicts an exemplary embodiment of a rehabilitation
chair 1300 with chair arms 1330, 1332 that are separate from the
chair 1300. The chair arms 1330, 1332 are shown connected to ball
mechanisms 1320, 1324 similar to the ball mechanism 1322 of the
chair itself. Optionally, this chair is provided with knee supports
1340 which provide CPM to the patient for the strengthening of the
back. CPM is used for the treatment of back pain and is discussed
in more detail in below. This chair 1300 is optionally used with
the attachments and in the manner described for chairs 110 and
600.
[0123] Alternatively, chair 1300 may be used to move a patient into
a position where he is supported only by his buttocks and while he
may be required to move arm(s) and/or leg(s) according to a certain
protocol. Optionally supports for the arms and the legs are
provided and are used to measure applied forces. Optionally, chair
1300 has a back which flattens out so that the patient can exercise
lying down, while having started from a standing or sitting
position.
"Reach Forward" Method
[0124] Flowchart 700 in FIG. 7 describes a method ("Reach forward"
method) that can be used for balance training. It is noted that
"reach forward" is merely a name for the method and in fact, the
patient reaching can be performed in any direction (e.g. up,
sideways, etc.). This method is illustrated with the chair of FIG.
2. At act 702, patient 104 is positioned on chair 110. At act 704 a
training program is determined. In this case a program to carry out
a "reach forward" method. At act 706, the chair parts are moved
into an initial position for exercise. For example, where a patient
is reaching for a target, chair arms may not be necessary or
desirable and hence may be removed.
[0125] The patient is instructed to move a hand to a start position
and then to reach forward as far and as fast a possible (act 705).
The chair provides assistance or resistance (act 715) depending on
measurements (act 712) it performs. For example, the chair system
measures (act 712) the person's body parts positions and
orientations and in response to these measurements the chair system
applies forces through the chair system to the person (act 715).
Optionally, the chair ability to move is limited to specific
desired ranges of motion. For example, only back/front motion is
allowed without sideways motion.
[0126] Graphical and/or audio and/or video feedback can be given to
the person during reaching (act 715). At act 714, analysis is
carried out by system 100. The analysis can be used to modify the
training program and/or to move various chair parts and/or provide
other feedback to the person 104. A therapy program may consist for
example of a number, N, of targets and a number, M, of reaches the
person is supposed to do for each target. For example, targets are
arranged over a broad range of motion (e.g. from straight up to
straight forward to sideways). Optionally, targets are clustered
close together. Targets are presented based on the patient's needs
for rehabilitation. In addition to varying target location, in an
exemplary embodiment of the invention the patient is instructed to
reach for the targets with variable speed and/or force. In order to
focus rehabilitation on a particular part of the patient's body,
parts of the patient may be constrained, or the patient may be
instructed to hold them still, to prevent "cheating" or unwanted
assistance from healthy body parts. Sensors are optionally used to
monitor "cheating". In an exemplary embodiment of the invention,
rehabilitation includes resistance training (e.g. use of
weights).
[0127] Patient 104 is instructed (act 705) to begin movement (act
708) with the hand resting on the armrest and moving slowly towards
a target. Targets may be positioned on a substantially vertical
board optionally attached to the chair, and at a distance the
person can reach and in front of the person. Sensors may be located
on the hand. In an exemplary embodiment of the invention, the board
includes lights (which indicate target locations) and sensors for
measuring force. Optionally, the board includes position sensors
and/or an actuator to move it to known positions. Optionally, the
board includes a track which a target can travel on, for example if
a sensor is provided on the target itself and not on the whole
board. The patient moves towards a target until the patient can no
longer move towards it or until the target has been reached. In an
exemplary embodiment of the invention, the person gets feedback
(act 715) on how close his hand was to the target (for example
using a proximity sensor or a position sensor on the hand), about
the velocity of moving the arm, and about the smoothness of the
movement. In an exemplary embodiment of the invention, the target
is a robotic arm tip which includes, for example force sensors
and/or position sensors. At act 716 it is determined if the patient
should continue exercise.
[0128] In an example of a writing task, a pen having a position and
a contact/pressure sensor is used, for example, as known in the art
of writing detecting whiteboards.
[0129] Turning now to FIG. 8, an illustration of a person reaching
forward using a rehabilitation chair 800 is shown in accordance
with an exemplary embodiment of the invention. In this case, the
target, N, is a bottle 810. In an exemplary exercise, the patient
804 is initially instructed to reach slowly towards the bottle 810.
After successfully reaching slowly towards the bottle, the patient
is then instructed to reach incrementally faster, and optionally
farther, towards the bottle. Optionally, the chair 800 assists the
patient with the reaching towards the bottle, by rotating forward
slightly. Optionally, an articulated back rest is used to "push"
the patient closer towards the bottle. In an exemplary embodiment
of the invention, sensors are used to monitor the status of the
patient and the chair as the patient 804 reaches towards the bottle
810. Analysis of the sensor measurements is used to detect
deficiencies in the patient's balance and strength. These
deficiencies are then rehabilitated specifically, optionally using
the apparatuses and methods described herein.
[0130] In an exemplary embodiment of the invention, the patient is
also encouraged to refine motor control by conducting exercises
such as pouring, or simulating pouring, from the bottle, while
maintaining his balance
An Exemplary "Correct Balance" Method
[0131] In an exemplary embodiment of the invention, a patient is
taught how to achieve correct balance using the measurements of
force exerted by a plurality of body parts and, optionally,
biofeedback. Optionally, a patient is rehabilitated to achieve a
balanced condition using different combinations of one or more
limbs. For example, the patient can receive balance rehabilitation
for balancing on only one foot, but not both at the same time. As
described herein, a patient's motion and/or balance can be measured
utilizing a plurality of sensors positioned on and around the
patient and on and around exercise apparatuses. Optionally, a
vector summation of all the measured forces can be calculated to
determine if a patient is correctly balanced. What is considered
correct balance can be determined by a fabricated goal balance
profile, by comparison to the patient's healthy profile, by
comparison to another person's healthy profile and/or by any other
reasonable method of establishing a standard of balance for the
patient. Optionally, a patient's balance profile is tracked over
the course of time in order to measure progress and to assist with
rehabilitation planning.
[0132] In an exemplary embodiment of the invention, the
measurements made by the sensors described herein are used to
determine if the patient is exerting too much force in a particular
area, or not enough force. For example, if the patient is relying
too much on the left leg and not enough on the right leg and is
therefore, not perfectly balanced, the sensors will measure the
imbalance and the system will attempt to assist the patient into a
balanced condition. Optionally, when the system 100 determines the
patient is in an off-balance condition, it provides feedback to the
patient in order to prompt the patient to respond in a manner that
will help to correct the off-balance condition. Feedback is
optionally provided to the patient in an audio format and/or on a
video display. In some embodiments of the invention, feedback is
delivered in the form of vibration or other tactile stimulus.
Optionally, feedback is directed to a specific area of the body
which is not being used appropriately for achieving a balanced
condition.
Additional Chair Details
[0133] As described above, various sensors can be affixed to the
patient and/or the various chair components in order to accurately
gauge the progress of the patient's rehabilitation in exemplary
embodiments of the invention. A wide variety of sensors can be used
either alone, or in combination, for this purpose. The sensors can
be loosely divided into two types: the first are sensors pertaining
to the patient (e.g. body part location, physiological responses),
while other sensors are used to gauge the disposition of the chair
(e.g. position/orientation of chair components).
[0134] In order to gather information on the patient during
rehabilitation, sensors are optionally attached to the patient's
body. For example, positional sensors are optionally attached to
body parts such as the arms, chest, head, feet, hands, and/or legs.
These positional sensors are used to determine the location of the
various body parts while exercising. Analysis of these location
measurements assists with recognizing overall patient movement,
including overcompensation for weak body parts by stronger body
parts and the like. Used in conjunction with the "reach forward"
method of rehabilitation, for example, positional sensors can
estimate the accuracy and precision of the patient's reach.
[0135] Another type of sensor that is optionally used during a
patient's rehabilitation is a pressure sensitive sensor. Through
the measurement of a patient's exerted pressure in a particular
location (e.g. chair arm tip 242), it can be determined how
dependent the patient is on that body part for stability and/or
body control. Pressure sensors are optionally used with the hands,
legs, feet, arms, rear end, head, and torso. In an exemplary
embodiment of the invention, analysis of the collected pressure
data illustrates if the patient is balanced, and if not, where the
deficiencies in balance are situated. For example, pressure sensors
used in conjunction with the "going with" method can determine if
the patient's balance is deficient if during chair movement the
patient exerts an inordinate amount of pressure on a particular
chair arm tip. This inordinate amount of pressure would tend to
indicate that the patient can't adequately balance when moving in
that direction and as a result relied on the chair arm tip to
maintain balance. The patient's rehabilitation program could then
be tailored to work on balance moving in that direction to overcome
the deficiency. Force can optionally be measured using pressure
sensors. Used in conjunction with the "reaching forward" method, a
patient who extends towards a target can activate a pressure sensor
which detects how much pressure (i.e. force) the patient could
exert on the target. In an exemplary embodiment of the invention,
pressure sensors are used for measuring both strength and balance
in combination.
[0136] In an exemplary embodiment of the invention, other sensors,
such as muscle tension and electromyography ("EMG") sensors are
used to monitor a patient's physiological responses to
rehabilitation. Analysis of measurements taken from these sensors
help identify which parts of the patient require further
rehabilitation and allow planning of future rehabilitation
strategy. Optionally, pulse measurement or breathing rate sensors
are used.
[0137] In addition to or alternatively to sensors for monitoring
the patient, sensors are optionally provided for monitoring the
operation of a rehabilitation chair in an exemplary embodiment of
the invention. Sensors are optionally affixed to any component of
the rehabilitation chair for tracking for example the position of,
power and/or force applied to those components. One type of sensor
of this purpose is a magnetic-based position tracking sensor.
Ultrasonic and optical position sensors are known as well. Of
particular use is comparing sensor readings from the chair with
sensor readings from the patient. Comparative analysis of this data
indicates patient response to specific movements from the chair.
Deficiencies in the patient in response to these chair movements
point to areas needing further rehabilitation.
[0138] In an exemplary embodiment of the invention, motive force
for the chair is provided by at least one motor in operational
communication with the ball mechanism 222. Optionally, at least one
brake is provided to prevent movement of the ball mechanism 222 in
a particular direction, or at all. Furthermore, a motor is
optionally provided to assist with chair motion along the z-axis.
In an exemplary embodiment of the invention, a position encoder is
used with a motor in order to determine the amount of movement
imparted to the ball mechanism 222.
[0139] Speed and directional movement of the chair is variable, in
an exemplary embodiment of the invention. As shown in FIG. 6, the
chair optionally moves in the x, y and z axes. The speed of the
motor is adjustable to provide movement to the chair ranging from
stop to relatively fast. In addition to active control of the chair
rotational speed, the chair can be completely unfettered, or
provided with only intermittent motor movement Optionally, the
chair moves to provide supplemental support for patient movement.
In an exemplary embodiment of the invention, the chair responds
slowly to gravity, for example including friction (e.g., a brake or
using the motor), which simulate lower gravity. Optionally,
responses to a user's motion can be at normal or higher than normal
speed. Optionally, a safety restriction on miss-balancing (e.g.,
rotational movements) of the chair is also provided. Alternatively
or additionally, there is a threshold below which the chair does
not misbalance.
Chair Usage
[0140] It should be noted that the rehabilitation devices described
herein may be used at home, at care centers, such as old age homes,
at hospitals and at rehabilitation centers. In an exemplary
embodiment of the invention training can be done by using games
and/or competitions and/or tournaments. Optionally, multiple chair
systems are interconnected by a network, for example a LAN or an
Internet 155 on FIG. 1.
[0141] In an exemplary embodiment of the invention rehabilitation
can be with or without assistance. For example, once a patient sits
down, he can exercise without assistance. Some patients will
require assistance and/or strapping-in. Optionally, monitoring
and/or management of a rehabilitation session is effected remotely,
for example over telephone lines or over an Internet, possibly form
a central location.
[0142] In an exemplary embodiment of the invention, a chair is used
for testing a patient's abilities. Optionally such a chair is used
for follow-up of a patient that completed rehabilitation.
[0143] Optionally, during rehabilitation, a record is kept of
progress of a patient. Possibly lack of progress is linked to
underlying organic problems which can be treated and/or reported to
a treating physician.
[0144] In an exemplary embodiment of the invention, a first use of
the chair system includes calibrating of the chair system to the
patient, entering of user specific information and/or testing
patient abilities. Optionally, the chair is adjustable, for
example, in height, width and/or back angle. Optionally, cushions
may be provided to suit certain physical deformations and/or forms.
An initial set of exercises may be determined and then this set is
expanded and/or changed according to progress and/or time.
Optionally, one or more benchmarks are defined, for example ability
to lift up a book from a table, which, once passed, rehabilitation
is deemed completed (or moving to a different stage). Also, as part
of gait training, once balance is sufficiently well developed, a
patient may be trained only in standing position. Optionally,
sitting position is retained as it allows balance training under
less physical demanding conditions.
[0145] In an exemplary embodiment of the invention, the chair is
used to rehabilitate a patient at least partially in water; this
may require waterproof parts and/or using wireless rather than
wired connections.
[0146] In an exemplary embodiment of the invention, for example for
gait training, the feet of the patient rest in pedals which can
move in the X-Z plane. Optionally, the pedal can also rotate (or
resist or assist rotations) in the X-Z plane. Optionally, the two
pedals are moved in manner which simulates walking.
Chair Variants
[0147] Some embodiments of the invention may have different designs
and/or settings and/or motions. In an exemplary embodiment of the
invention, seat 105 may have various shapes and slopes. Optionally
the seat has a backrest. Optionally the backrest is height
adjustable. Optionally the backrest tilts or moves relative to
seat. Optionally the backrest has a head support. Optionally the
seat and backrest may move independently or dependently. In an
exemplary embodiment of the invention, the backrest is articulated
with a plurality of segments, said segments capable of providing
directed support to specific portions of the patient's back.
Support is optionally provided in response to patient motion during
exercise. In an exemplary embodiment of the invention, articulation
is supported by powered joints between chair segments. Segments may
be arranged, for example, vertically and/or horizontally along the
chair back. In an exemplary embodiment of the invention, the
powered joints include a motor for rotating a joint. An optional
positional encoder may be provided for the motor in addition to or
alternatively to position and/or orientation sensors for each
segment. The above exemplary embodiment is optionally used to
support a patient while exercising standing up or sitting down.
[0148] In an embodiment of the invention, the patient is attached
to a harness suspended above the rehabilitation chair, in order to
remove some body weight from the chair. Optionally, the harness is
used to provide extra support to the patient during exercise.
Optionally, the harness is also used as a safety device, to prevent
the patient from falling to the ground during rehabilitation.
[0149] In an exemplary embodiment of the invention, the seat can be
adjusted to person 104 body parameters, such as patient height
and/or body weight.
[0150] In an exemplary embodiment of the invention, the
rehabilitation chair is used in conjunction with foot supports.
Optionally, the foot supports include sensors (e.g. pressure
sensors) or attachment means, such as straps. Optionally, the foot
supports can move, for example for rising the foot or rotating the
foot in one or more orientations.
[0151] In an exemplary embodiment of the invention, the
rehabilitation chair is used in conjunction with floor mats.
Optionally, the floor mats include sensors (e.g. pressure
sensors).
[0152] In an exemplary embodiment of the invention, the
rehabilitation chair is used in conjunction with knee supports,
which may include features such as described for the foot supports,
including optionally a motor to bend the knee and/or a sensor to
tell a knee position and/or enforce a knee position.
[0153] In an exemplary embodiment of the invention, the
rehabilitation chair is used in conjunction with leg supports,
which may include features such as described for the foot
supports.
[0154] In an exemplary embodiment of the invention, the
rehabilitation chair is used in conjunction with at least one arm
support, which may include features such as described for the foot
supports, for example using a ball mechanism based for articulation
thereof in 2D or 3D and/or for rotations.
[0155] In an exemplary embodiment of the invention, a ball
attachment is provided so a patient can practice kicking the ball
while maintaining balance. Similarly other attachments (possibly
not physically attached) are provided. Optionally, a wireless
position sensor with adhesive or other attachment means is provided
and which can be applied to objects of daily use, such as a book or
a teakettle, so that a patient can practice with daily use objects.
Optionally, the "reach-for" method is supported by a ball which is
through by the system and a user must catch it. Optionally, a
robotic arm is moved to a location and then moved away after a time
window has elapsed, to provide similar behavior.
[0156] In an exemplary embodiment of the invention, pressure
sensors are provided in one or more of a foot pad/rug, arm rest,
seat cushion and seat back. Optionally, such pressure sensors
indicate a pressure applied by a patient during an activity.
Optionally, the sensors indicate an exact point of application of
pressure (e.g., to within 5 cm), so that a point of contact of the
patient can be estimated. Alternatively or additionally, fixating
means is provided to link the patient's body parts to the pads.
Alternatively or additionally, a position sensor on the patient's
body part generates an indication of a relative location between
the body part and the pressure sensor.
[0157] Optionally, the pressure sensors include torque sensors,
which may be used to detect not only a degree of pressure but also
a direction (in the plane of the pressure sensors) to which force
is being applied.
[0158] In an exemplary embodiment of the invention, the
rehabilitation chair is fitted with a manually applied brake (with
optionally indicating scales). The patient optionally begins
rehabilitation with high friction (i.e. more stable) and as the
patient improves stability while exercising (e.g. reaching for an
object) the patient then incrementally decreases the friction of
the chair in order to improve strength and balance. As noted above,
the stability of the chair need not be constant with angle of the
chair. It can also be non-constant over the course of an exercise.
For example, at first a relatively large safety zone is provided
where unbalancing forces applied by a patient are ignored. After a
while, the size of the zone decreases, for example based on
previous performance so that the patient has to be more careful not
to apply such unbalancing forces, or be prepared to correct for
them.
[0159] In an exemplary embodiment of the invention, the
rehabilitation chair vibrates, for example to provide massage or
for feedback (e.g., that stability is about to be lost).
[0160] In some embodiments of the invention some parts can be
exchanged with similar parts. For instance seat 105 may be replaced
with some other types of seats, such as a bicycle seat.
Controller
[0161] In an exemplary embodiment of the invention, controller 150
controls chair 110 according to a program. Optionally or
additionally the controller is a personal computer or a dedicated
embedded computer. The controller controls movable parts of the
chair such as chair arms 230 and/or 232, in an exemplary embodiment
of the invention. The controller executes a rehabilitation method,
such as described by flowchart 500 of FIG. 5. A program may be
prepared in advance, and may be devised after conducting
preliminary tests.
[0162] A rehabilitation method can be chosen, for instance by using
a menu and a user input device. Optionally various parameters such
as age and gender can be provided by a user input device.
[0163] The controller may control movements of movable part of
chair 110 according to a program. For example, the controller may
cause a chair seat of chair 110 to move in a way that will lift the
person sitting on the chair in order to assist him standing from a
sitting position.
[0164] In an exemplary embodiment of the invention, rehabilitation
chair 110 has sensors or other means of measurements so there is no
need to put sensors on person 104. The chair may be able to produce
data of positions and/or orientations of chair parts and/or person
parts. For example X axis, Y axis, and Z axis positions of person
104 for the full body and/or parts of the body. The chair may be
able to produce data of other measurements such as pressure put by
a human body part, or weight of person 104. Data is transferred
from the rehabilitation chair 110 to the controller 150 as is
illustrated by arrow 194. Data may be also transferred to a
controller 150 from the data acquisition system 140, as is
illustrated by arrow 192.
[0165] In an exemplary embodiment of the invention, controller 150
processes input data coming from rehabilitation chair 110, and from
data acquisition 140. Optionally various user-input devices 170 are
used to interact with a user. Optionally the computer outputs to
output devices such as a display 160, a video unit 162, and an
audio unit 164. An audio unit may be used for providing audible
and/or speech instruction and/or feedback. An external connection
for connection to a remote computer is optionally provided.
Optionally, the controller is in communication with a network such
as a LAN, WAN and/or the Internet.
[0166] In an exemplary embodiment of the invention, controller 150
performs at least one of the following tasks: it runs various
programs; it controls chair 100; it controls the motion of parts of
chair 110; and it transmits X-axis, and Y-axis, and Z-axis
positions and rotations to chair 110.
[0167] In an exemplary embodiment of the invention, the controller
controls device 110 or parts of it according to a program prepared
in advance. Optionally, the controller controls multiple devices
and/or rehabilitation systems. A program may be prepared after many
preliminary tests. The program carries out a rehabilitation method.
An operator or person 104 can choose a rehabilitation method, by
using a menu and a user input device. Optionally various parameters
such as age and gender can be provided using a user input device
170.
[0168] In an exemplary embodiment of the invention, patient
performance is tracked over the course of the rehabilitation
program. Optionally, the controller 150 performs the tracking. As
the sensors 130 gather data regarding the patient and the chair,
the results are stored on a database accessible to the controller
150. The controller 150 is then used to sort and process the data
stored on the database.
[0169] It should be noted that some implementations of device 100
include no computer. Some implementations require no electrical
power. In one example, a mechanical computer (e.g., a mechanical
cam follower which guides the movement of the arm) is used to
control the device parameters. Optionally, as noted above, the
chair is manually operated.
Pain
[0170] In an exemplary embodiment of the invention, the chair
system can detect pain, for example automatically, based on muscle
tension, breathing or pulse rate, or manually, for example by user
input (e.g., voice or switch). In some embodiments of the
invention, an abrupt stop and/or change in exercise motion is also
construed as an indicator of pain.
[0171] In an exemplary embodiment of the invention, the chair
system (or other rehabilitation device, such as a robotic arm) is
used to explore the range of motion and/or muscular effort at which
pain occurs and the level of pain. Optionally, a patient is taught
motions which will avoid the pain.
[0172] In an exemplary embodiment of the invention, rehabilitation
motion trajectories are selected to take into account pain, for
example, to try to expand the non-pain envelope or to limit the
amount of pain in a session. Optionally, the training session is
constructed to force the patient to work close to his pain
threshold in order to expand his possible range of motion (and
range of force) without pain. It should be noted that many
activities related to balance activate a wide range of muscle and,
so, are likely to cause unexpected pain. By showing the patient
what these motions are (e.g., in a safe situation), the patient may
be able to learn to avoid activating such muscles. Alternatively,
rehabilitation may include a required dosage of activating certain
muscles (e.g., so they do not atrophy), and a patient can be made
aware that the amount of pain he will experience is both
predetermined and required.
[0173] In an exemplary embodiment of the invention, position and
other sensors are used to provide feedback if a patient moves a
body part in a manner which is unnecessary and may cause pain or
physical damage (e.g., for an unstable joint). Optionally, a pain
warning as well as a safety warning may be supplied. Optionally the
rehabilitation system prevents painful motions except where
otherwise indicated, thus possibly increasing patient confidence in
the system.
Balance Training
[0174] In an exemplary embodiment of the invention, a patient is
rehabilitated in a chair 110, 600, or 1300. In order to improve a
patient's balance, the chair is initially configured such that the
ball mechanism on which the chair sits does not rotate or pivot. As
the patient commences exercises and progresses through the
rehabilitation schedule (performing exercises such as "go with" and
"reach forward"), the chair is given an incrementally increasing
range of motion. Ideally, the patient is able to maintain balance
on the rehabilitation chair without assistance from the brake or
chair motor. In order to determine whether it is appropriate to
increase the range of motion of the chair, the patient is monitored
with sensors of the type described in above and elsewhere
herein.
[0175] The performance of a healthy subject can be measured using
these sensors in order to determine a basal level of performance.
In the alternative, a goal level of performance can be determined
without regard to healthy subject testing. As the paretic patient
performs exercises, the sensors measure the patient's performance.
In an exemplary embodiment of the invention measurements are taken
of various body parts and then the body part measurements are
compared to one another in order to gauge their relative use.
Optionally, multiple patient limbs and/or body parts are measured.
The exercise measurements are compared against the goal performance
numbers and deficiencies are noted. The rehabilitation program is
then adjusted based on these deficiencies. For example, if the
patient tries to stand up, a pressure sensor under each foot
measures the pressure exerted by the patient. Ideally, the pressure
exerted by the two feet is the same in a standing position.
However, if one foot is favored, it is likely an indication that
the patient needs further rehabilitation. In exemplary embodiments
of the invention, the same technique is applied to exercises
involving the arms and hands, or for macro-exercises, such as
reaching.
[0176] In some embodiments of the invention a "reach balancing"
method is used, in which a patient needs to catch or throw a small
weight and/or balls. These activities require shifting one's
balance. In an exemplary embodiment of the invention the balls will
automatically be thrown towards the patient by a device controlled
by the apparatus. As the balls near the patient, the patient is
expected to reach out and try to catch the balls in the air. This
type of activity typically results in the patient being off center,
and therefore, it practices balance. Depending on the patient's
therapeutic needs, the balls can be thrown towards the patient from
specific directions. In the alternative, the patient can throw
balls in specified directions in order to rehabilitate balance.
Optionally, this exercise is performed while sitting down in a
rehabilitation chair 110.
[0177] In some embodiments of the invention, the rehabilitation
chair instigates movement to a non-balanced position and the
patient is expected to correct in order to establish balance.
Optionally, the arms and/or foot rests instigate movement to a
non-balanced position and the patient is expected to correct in
order to establish balance. Movement of the patient in terms of
speed of correction, direction of corrective movement, if
correction was completed, etc. can be measured by the sensors used
in conjunction with the rehabilitation system. Optionally, any
deficiencies in balance correction are exercised specifically.
[0178] In an exemplary embodiment of the invention, the
rehabilitation system provides supplemental movement to the
patient's natural movements in order to restore a balanced
condition. This is achieved by sensing the position and movement of
the patient, comparing these measurements to a known balanced
condition and forecasting whether that balanced condition will be
met, and then supplying the appropriate motive force to the chair
in order to compensate for any calculated under or over correction
by the patient.
[0179] In some embodiments of the invention a virtual reality (VR)
type display or a television display are provided, for example to
show feedback, and/or to show instructions and/or to make the
activity more interesting and/or to distract person to ease his
pain. A person can react to instructions and/or feedback on a
screen and this can strengthen his muscles, improve balance, and
improve some motions.
[0180] In some exemplary embodiments, a chair system combined with
video based exercises that create the illusion of movement is used
to improve balance and reduce dizziness.
[0181] In an exemplary embodiment of the invention, foot pedals are
used in conjunction with the chair to simulate riding a bicycle.
Sensors are used to determine if the patient is able to pedal and
maintain a balanced condition.
[0182] In an exemplary embodiment of the invention, a balance
exercise comprises leaning on a table (e.g., with a pressure
sensitive pad) while getting up or sitting down. Uneven application
of pressure may indicate a balance-related problem which can be
rehabilitated. Optionally, one or more vibrational or other
stimulatory patches/units may be attached to body parts and
generate a stimulation prompting the patient to change his
activity. Optionally, the robotic arms of the rehabilitation system
provide such feedback (e.g., with a pad attachment for leaning on,
rather than a handle), for example by moving or vibrating.
[0183] Another exemplary exercise is lifting a leg while remaining
seated. Another exemplary exercise is standing on one foot, for
example with a partially supporting chair as described below.
Leg Lifting and Back Treatment
[0184] In FIGS. 11 and 12 a chair based rehabilitation device 1200
is shown, in accordance with an exemplary embodiment of the
invention. Device 1200 comprises a seat 201, a base 205; a
ball-based mechanism 203; foot supports 1220 and 1222; and knee
support 1240 and 1242. Optionally, the knee support is one piece.
Device 1200 can perform CPM of the back muscles while the patient
is sitting. It can be used to improve back mobility, reduce back
pain, and reduce muscle tension. Typically, treatment of the back
while in a sitting position is more favorable than treatment of the
back while lying down. Exercising while lying down (thus, adding
more stress to the back during changing of position) can cause
further back discomfort and/or injury. In an exemplary embodiment
of the invention, CPM on the rehabilitation device is performed by
raising and lowering the knee supports 1240, 1242, and optionally
foot supports 1220, 1222, either together or separately. The
raising and lowering of the supports is optionally repeated as many
times and/or in as many sessions as the patient's rehabilitation
requires.
[0185] In an exemplary embodiment of the invention, the various
sensors are used to gauge if the CPM (or other exercise is being
properly administered and/or its effect on the muscles (e.g., using
EMG sensing).
[0186] Optionally, the rehabilitation chair 1200 rotates to provide
exercise to the patient. The chair 1200 is capable of rotating in
three dimensions around the x, y and z axes. Rotation can be
achieved along one, two or all three axes in combination. In an
exemplary embodiment of the invention, the knee supports 1240, 1242
and/or foot supports 1220, 1222 are in motion while the chair 1200
is rotating. Such exercise can be gentle exercise designed to move
the spine and exercise back and/or stomach muscles and/or extend
their range of motion. In an exemplary embodiment of the invention,
such motions are used to treat pain, for example, by stretching or
activating muscles which providing support to the body. Optionally,
the chair includes heaters or vibrators, to help with pain.
[0187] In an exemplary embodiment of the invention, CPM exercises
are accompanied with hand and arm exercises, which are optionally
synchronized to the CPM. Hands and arms can be exercised by
providing arm supports such as elements 1330 and 1332 shown in FIG.
13. In addition, leg motions causing spinal flexion can be
non-passive, for example, assisted or against resistance.
[0188] In an exemplary embodiment of the invention, non-CPM
exercises are also used to help in treating back problems. For
example, the "reach forward" exercise described herein not only
rehabilitates balance, but can also be used for building back
strength. Optionally, non-CPM exercises are accompanied with hand
and arm exercises. Hands and arms can be exercised by providing arm
supports such as elements 1330 and 1332 shown in FIG. 13.
[0189] In an exemplary embodiment of the invention, chair 1200 or
other chairs are used to teach correct motions to a patient, for
example to avoid overstraining a muscle. In one example, a reaching
action is requested from a user and the user is told during the
action (e.g., using audio or speech signals) if the motion is
correct and/or what is incorrect. Optionally, stimulation units are
provided to specifically indicate to the patient which motion is
incorrect. In another example, various typical daily motions, such
as turning torso, lifting objects, reaching and/or applying forces
are taught to the patient by example. Optionally, the system
receives feedback form the patient if one of the motions does cause
pain. In such a case, the system and/or a therapist reconfigures
the "correct" motion. Correct motions might also include training
in activating muscles in a certain sequence and/or refraining from
applying to much strain to a muscle, joint or other body parts. All
these are optionally taught, e.g., using teaching by example to the
patient.
Standing Up and Sitting Down
[0190] An activity often carried out using a chair is sitting up
and sitting down. As people age and/or when they suffer cognitive
and/or physical damage, these tasks may become difficult. In an
exemplary embodiment of the invention, a chair rehabilitation
system can lead a patient through a correct trajectory of sitting
down and getting up. Such leading can include, position, velocity
and force feedback, also when the patient leans on various objects
(such as a table or arm rests). Alternatively or additionally, the
chair can provide moving parts, such as chair arms, a seat bottom
and a back rest that actually move the patient along the
trajectory. A pain switch is optionally provided for the patient to
complain of pain. Various sitting-down and standing up exercises
may be provided, for example, by moving arm rests, changing a
degree of assistance of the chair and/or placing constraints on the
trajectory a patient can and/or may follow.
[0191] Turning now to FIG. 9A, a patient 904 is shown in a
rehabilitation chair 900 in a fully seated position. In an
exemplary embodiment of the invention, the patient's hands grip the
chair arm tips 940 and/or 942 for support. The patient's feet are
flat on the floor. The patient desires to rise from the fully
seated position to a standing position. FIG. 9B illustrates how the
chair 900 inclines the rear of the seat 905 to slowly bring the
patient 904 up to a standing position. Optionally, the seat 905
rises in the z axis in combination with inclining the rear of the
seat 905. FIG. 9C illustrates the patient standing with the feet
flat on the floor, having been eased to a standing position by the
seat 905. Optionally, the patient relies on the arms of the chair
936 and/or 938 for support. Optionally, the chair arms actually
move the patient. Alternatively the chair arms measure force
levels. Optionally, the chair arms are provided with arm rests (not
shown). Optionally, the chair 900 has no chair arms. Optionally,
the chair 900 has an articulated back rest, which can exert
pressure on the patient 904 in order to assist the patient off the
seat 905. In some embodiments of the invention, the articulated
back rest is used to modify the positional relationship of the seat
to the patient's back.
[0192] In an exemplary embodiment of the invention, sensors are
used to monitor the status of the patient and the chair as the
patient moves into a standing position. As the patient exerts force
at various points, for example, the floor and/or footrests, the
arms of the chair, the chair arm tips, this force is measured.
Analysis of the sensor measurements is used to detect deficiencies
in the patient's balance and strength and to quantify the patient's
"quality of standing." These deficiencies are then rehabilitated
specifically, optionally using the apparatuses and methods
described herein in order to improve the quality. In an exemplary
embodiment of the invention, the chair 900 is provided with a seat
905 that rotates in order to facilitate patient exercise. In an
exemplary embodiment of the invention, a patient exercises by
standing up and/or sitting down in a chair that rotates.
Optionally, the force exerted by the patient during standing up and
sitting down is measured for identification of deficiencies in
ability.
A Support Chair
[0193] FIGS. 14A-14C illustrates a support chair 1400 in an
exemplary embodiment of the invention. In FIG. 14A the chair is
lowered. FIG. 14B shows the chair 1400 in a higher position than in
FIG. 14A. In an exemplary embodiments of the invention, the chair
1400 moves up and down depending on the individual needs of the
patient. A torso support 1404 (e.g., straps) can be optionally
included with the support chair. FIG. 14C illustrates the support
chair 1400 where the chair seat is in a nearly upright position
where in some exemplary embodiments of the invention a patient is
assisted into standing from a sitting position. Optionally, the
back of the chair can bend backwards, to support a patient in a
semi-prone or lying down position.
[0194] In an exemplary embodiment of the invention, a support chair
is used when a patient is performing a balance activity in a
semi-sitting position, with the chair providing partial support.
Example exercises include kicking a ball while standing (or leaning
on the chair as if it were a wall) and standing on one foot.
Training in Daily Life Activities
[0195] In an exemplary embodiment of the invention, a
rehabilitation chair system is used to help rehabilitate a patient
to achieve daily activities, such as eating at a table, reading a
book, brushing teeth and washing dishes. In all of these activities
a patient applies force away from his center of gravity potentially
causing a balance problem or a problem in accurate application of
force.
[0196] In use, a hand of the patient is strapped to a movable tip,
for example 240, of chair system 110 and the patient attempts to or
is guided through a daily activity such as picking up a fork.
Optionally, the effect of the motion on the patient's balance is
indicated to the patient, for example, by allowing the chair to
miss-balance in slow motion. Optionally, a torso support is
selectable electronically releasable and is slowly released to show
the patient the effect on torso position of misbalancing while not
applying correct corrective actions.
[0197] Optionally, an add-on table section with suitable sensors
(e.g., contact and/or pressure) is provided. Optionally, a
whiteboard for writing on is provided.
[0198] In an exemplary embodiment of the invention, device 110 is
used for one or more of training a patient to do activities related
to daily life, testing the patient's current ability to do such
activities and/or monitoring a patient's ability.
Attachments
[0199] As noted above, some implementations of device 100 include
various attachments 120. Attachments may include: medical
peripherals 180 such as ECG; Cameras; a carpet, optionally provided
with pressure sensors; a handle, optionally to report pain; devices
to assist in various operations, such as to help a person standing;
a working area such as a horizontal table; a vertical reaching
target; different types of handles and grips which the person 104
holds and which are optionally connected to the rehabilitation
chair at the chair arm tips 240 and 242. In some exemplary
embodiments of the invention, restraints are used to immobilize
selected portions of the patient's body. For example, a restraint
can be used to hold a patient's arm to armrest 250 while the
patient tries to flex the wrist (and thereby raise and lower the
hand from a horizontal to vertical position) of that arm.
Optionally, a fixed or an articulated headrest are provided.
Optionally, the head rest includes means to prevent and/or
encourage rotation of the head.
Safety
[0200] Chair 110 optionally includes safety means, such as, a
brake, a fuse, an emergency button or switch. In an exemplary
embodiment of the invention, one or more safety features are
provided to prevent injury to a patient. For example, one or more
of the following safety mechanism may be used:
[0201] a) Dead man switch. If a patient releases this switch (or
touches a suitable button) movement of device 100 is frozen and/or
all forces and resistance brought to zero. Other "safe harbor"
situations can be defined instead.
[0202] b) Voice activation. Voice activation and/or deactivation
may be provided, to allow a patient to shout the system to a
stop.
[0203] c) Analysis. Optionally, the actual movements and/or forces
applied by a patient are analyzed to determine if a threshold is
being approached or if the patient is experiencing undue
stress.
[0204] d) Mechanical fuse. This fuse tears or pops if a force above
a certain threshold is applied to a part of the chair.
Additional Processing
[0205] In an exemplary embodiment of the invention, controller 150
generates signals indicative of forces, positions velocities and/or
accelerations. Optionally, these signals are further analyzed. In
one example, a biomechanical model of a body is fed with the
signals, possibly indicating where a patient is deficient. In
another example, analysis includes applying an FFT or other means
to extract a frequency behavior of the misbalance. In some cases,
such frequency behavior can indicate a source of the problem, a
physical location of the problem, a cognitive source of a problem
and/or suggest exercises for overcoming. For example, some types of
tremor which may cause imbalance may be caused by over straining
certain muscles. Even if no clear decision can be made, such
information may be useful for further exploring a particular body
part or ability.
[0206] Optionally, a model of the patient showing forces and/or
balance problems is presented to the user and/or a therapist.
Variants
[0207] In an exemplary embodiment of the invention, the
rehabilitation chair system 100 is comprised of modular parts. For
example, ball mechanisms 220 and 224 are optionally
interchangeable. Optionally, the rehabilitation chair can be used
without chair arm rests 250 and 252.
[0208] In an exemplary embodiment of the invention, rehabilitation
is performed on a platform (e.g. wobble board) instead of, or in
addition to, the rehabilitation chair.
[0209] In an exemplary embodiment of the invention, the rotational
abilities of the rehabilitation chair 110 are used to make the
patient 104 dizzy and/or test susceptibility to dizziness. In an
exemplary embodiment of the invention, the seat of the chair is
moved in small arcs or in a circle. Speed may be increased over
time. As the patient attempts to recover balance in the dizzy
state, the patient's movements are measured by sensors and then
analyzed to detect deficiencies in the patient's balance recovery
abilities. Deficiencies are targeted for rehabilitation as is
required in order to restore the patient's nominal balance recovery
capability. Alternatively or additionally, the chair includes means
for translational motion, which may also be used to cause dizziness
or for other exercises. Optionally, a display showing images
matching or not matching chair motions are used, to train and/or to
test for dizziness susceptibility.
[0210] In an exemplary embodiment of the invention, the platform is
adapted to fit under existing chairs, possibly providing a leg
rest, so that rehabilitation and/or rehabilitation for balance can
be provided on a standard chair. A set of cabled or wireless sensor
may be provided as well. It should be noted that some of the
exercises described herein may also be performed while standing up,
optionally on one of many known moving platforms, while optionally
providing one or more robotic arms for support, kinesthetic
feedback and/or guidance. Similarly, a robotic arm module or a leg
raising module may be provided in a form which can be latched on
(e.g., using a strap) to an existing "standard" chair.
[0211] Training of balance and sitting down and for pain is not
limited by the particular examples shown above. In particular,
balance can be used, for example for supplementing the fine motor
control rehabilitation methods described in U.S. Pat. App. No.
60/566,079, the disclosure of which is incorporated herein by
reference. For fine motor control, balance should be maintained by
the patient while applying fine motor control. Fine motor control
tasks can be carried out while sitting down.
[0212] Balance rehabilitation can also be combined with neural
rehabilitation. For example, U.S. Pat. App. No. 60/604,615, the
disclosure of which is incorporated herein by reference uses
neuronal sensing to determine when an action should be triggered.
EEG signals can be used as feedback for balance-related
activities.
[0213] Balance training can be used with EMG. For example, U.S.
Pat. App. No. 60/566,078, the disclosure of which is incorporated
herein by reference. Balance sensing can be used in addition to EMG
or to determine when EMG should be delivered.
[0214] Balance training can be used with gait training, for example
such as described in U.S. Pat. App. No. 60/633,428, the disclosure
of which is incorporated herein by reference. In one example,
sitting balance training is used prior to or as an adjunct to gait
training.
[0215] Music can be used for balance training, for example such as
described in U.S. Pat. App. No. 60/633,429, the disclosure of which
is incorporated herein by reference. In one example, music is used
to indicate balance between body sides. A channel which is too loud
may be used to indicate a body portion applying too much force.
Silence may be used to indicate balance, while a wobble will
generate a cyclical tube and as balance is lost and alarm may
increase in amplitude.
[0216] The present invention has been described using detailed
descriptions of embodiments thereof that are provided by way of
example and are not intended to limit the scope of the invention.
The described embodiments comprise different features, not all of
which are required in all embodiments of the invention. Some
embodiments of the present invention utilize only some of the
features or comprises combinations of the features. Variations of
embodiments of the present invention that are described and
embodiments of the present invention comprising different
combinations of features noted in the described embodiments will
occur to persons of the art. The scope of the invention is limited
only by the following claims.
* * * * *
References